Getting Proven Addiction Treatment Options with Ambetter
Table of Contents
- Getting Proven Addiction Treatment Options with Ambetter
- What Is Ambetter Health Insurance?
- What To Know About Ambetter Insurance Coverage
- How Ambetter Insurance Benefits People Seeking Addiction Treatment
- The Importance Of Rehabs That Accept Ambetter Insurance
- Identifying an In-Network Ambetter Treatment Facility
- What Are The Types Of Ambetter Substance Abuse Treatment?
- How To Choose The Right Treatment Center for Your Needs
- Get an Ambetter Treatment Program for Lasting Recovery Now
- Top Rehabs That Accept Ambetter: Only a Call Away!
- Medically Reviewed By
In 2020, more than 16,000 drug and alcohol rehab centers in the country served over a million people. This may seem like a sizable amount, but it represents a small fraction of those who would benefit from rehab services. For too many people, the perceived inability to pay for treatment plays heavily on their minds and keeps them away from needed help.
If you have an Ambetter policy and want to know about finding top rehabs that accept Ambetter insurance to get treatment as affordably and effectively as possible, keep reading!
What Is Ambetter Health Insurance?
Ambetter insurance has served over two million members since 2014 with its variety of healthcare services. It provides wide-ranging plans on three levels: gold, silver, and bronze. Some states offer additional plan options that include more coverage.
Benefits may include dental, maternity, and newborn care, mental health services, pediatric services, prescription drug coverage, preventive care, substance abuse services, telehealth, vision, wellness, and many more programs.
In partnership with local health insurance providers, Ambetter ensures that members with a substance use disorder will receive the appropriate care they need without the additional stress of the impact on their pockets. As it is, many people suffering from drug or alcohol addiction are often already afflicted with co-occurring mental health disorders.
Seeking addiction treatment is not cheap. A rehab center may offer inpatient treatment or outpatient treatment, or both. Either way, it may not be affordable for some as the process involves medical experts, medication, and temporary residence as in the case of inpatient addiction treatment.
Every treatment facility is different, so it’s difficult to pin down the real average cost of substance abuse treatment. However, DrugHelpline.org made a rough outline of the costs as follows:
- Medical detox – $500 to $1200+ per day
- Intensive outpatient treatment – $3,000 to $10,000 per month
- Outpatient rehab – $2,500 to $10,000+ per month
- Residential/inpatient treatment – $7,500 to $80,000 per month
It’s clear from the above figures that health insurance is essential in drug and alcohol rehab. The goal of Ambetter health insurance is for everybody who needs addiction treatment services to have access to them.
What To Know About Ambetter Insurance Coverage
As mentioned above, there are three levels of Ambetter insurance plans: gold, silver, and bronze. Just like their metallic hierarchy, all have values but gold costs the most expensive monthly premiums, though also the best coverage. For people who are fairly healthy, the bronze coverage is good enough to get the most basic and essential care.
When it comes to substance abuse treatment, the bronze plan may cover some selection of services, while the gold plan may provide full coverage. It is best to keep in mind that it always depends on the rehab center and the Ambetter addiction treatment coverage.
The most important thing is that you have coverage because treatment for addiction is included in the comprehensive health insurance reforms within the Affordable Care Act (ACA).
Sometimes referred to as Obamacare, the ACA enumerates 10 elements of essential health benefits, and substance use disorder is one of them. This Act means that health insurance providers are required to cover substance abuse treatment, at least in some form, and cannot bar providing assistance due to being termed a pre-existing condition.
Upon enactment of ACA into law, more people now have access to it as well as the ACA Marketplace that can offer those seeking treatment options from across a broad spectrum of providers and plans.
Let’s take a deeper look into the Ambetter insurance plans.
All insurance coverage packages of Ambetter offer the following essential medical care and wellness services:
- Medical emergency care
- Outpatient/ambulatory care
- Maternity and newborn care
- Pediatric care
- Preventive and wellness care
- Mental health care
- Substance abuse care
- Laboratory services
- Prescription drugs
- Therapy services
These are the details of each plan:
Also known as the Essential Care Plan, the bronze package is ideal for those who don’t earn much. The monthly premiums under this Ambetter insurance plan are fairly low yet it already covers your essential healthcare needs. However, if you need more medical care, the out-of-pocket costs are consequently higher.
Called Balanced Care, the silver plan is considered the best value and is also the most popular because it’s neither cheap nor too expensive. The monthly premiums are mid-range and the out-of-pocket costs are not that high, especially if you are also eligible for financial assistance.
Gold is considered the best of the Ambetter health insurance plans. If you can afford it, you’re advised to purchase one. In exchange for higher monthly premiums, you get limited out-of-pocket costs, and in many instances, no extra cost at all.
It is worth noting that if you are trying to select an Ambetter Insurance plan using the ACA Marketplace, gold plans may look as though they are costlier, but may end up saving you or your loved one significant amounts of money when considering the overall costs of attending rehab.
Other Ambetter Insurance Plans
Certain states and counties offer these additional Ambetter health insurance plans: Ambetter Select, Value, and Virtual Access.
How Ambetter Insurance Benefits People Seeking Addiction Treatment
There is more to Ambetter insurance coverage than just the essential health benefits, such as:
For substance abuse and mental health issues, Ambetter offers a mail-order pharmacy program that benefits people with insurance coverage for drugs or medications necessary to cope with such disorders. When you enroll in this program, you can choose from nearby in-network retail locations to have your order delivered right to your doorstep.
For a complete list of pharmacies and medications covered in your state, visit the Ambetter website.
In this 24/7 and $0 co-pay service, you have access to a physician rendering medical advice for non-emergency situations. The consultation is done through phone or video calls wherein the doctor may also prescribe medications. Most of these telehealth services are for physical illnesses, but you can check with your state if mental health situations are covered as well.
Know your message and data rates first before you start doing telehealth. This way, you can prepare for the session without running the risk of cutting off midway.
While this form of service may be helpful following a stay in rehab, it is not often helpful in providing overall levels of support and structure needed in detox and early recovery from substance use disorders.
Care Management Service
For people who require extra support for their conditions, Ambetter provides care managers who can coordinate the necessary services. They could also contact community resources to develop plans to manage one’s health. Care management service targets both medical and behavioral health needs. It is mostly for those who are incapacitated because of their illness.
This benefit may also apply to individuals with alcohol or drug abuse issues. During emergency substance abuse treatment where the person with the substance abuse disorder (and possible co-occurring mental health issues) needs immediate residential treatment, having this service is crucial.
Health Management Program
Services under this program are usually for chronic health conditions, and substance abuse is not considered one. Unfortunately, this is the case even if many have argued that addiction should be categorized under chronic diseases. After all, it can be a lifetime battle.
Nevertheless, Ambetter insurance coverage includes depression under the health management programs. This mental health disorder is often linked to drug and alcohol addiction, and the coverage doesn’t discriminate on the cause of the condition.
Under the health management program, one can find personalized assistance to manage their disease complications. It includes telephone support and access to educational tools, behavioral health services, and depression management programs.
24/7 Nurse Advice Line
This program is similar to the telehealth service except that nurses are the ones rendering medical advice. It’s crucial for people experiencing detox complications or withdrawal woes while undergoing outpatient treatment for substance use disorder. One can talk to a nurse who provides expert advice on dealing with a specific issue or if it’s time to seek emergency assistance.
The Importance Of Rehabs That Accept Ambetter Insurance
As mentioned earlier, addiction treatment is not cheap, so Ambetter insurance coverage is necessary. At least, it’s already a given that health insurance should cover mental health and addiction treatment as mandated by the Affordable Care Act.
In most cases, there will be out-of-pocket costs, which renders the real financial picture of addiction treatment very expensive. Ambetter insurance will ease anyone’s financial burden, even as it also depends on various factors: the state, healthcare plan, the type of rehab center (in-network or out-of-network facility), and the kind of addiction treatment.
There is also the matter of personalized drug and alcohol addiction treatment. Each case of substance use disorder needs a different treatment— outpatient addiction treatment would suffice in some, while residential treatment is necessary for others. Various medication-assisted treatment plans are available as well. Addiction treatment is not one-size-fits-all.
Therefore, Ambetter insurance coverage differs from one person to another. For peace of mind, it’s important to know one’s specific insurance coverage before availing of drug and alcohol addiction treatment. Of course, there are emergency situations that may be covered by the Ambetter insurance benefits.
Identifying an In-Network Ambetter Treatment Facility
Many treatment centers accept Ambetter insurance. One way to determine this is by checking whether they carry the Ambetter insurance logo which often means they will take forms of Ambetter health insurance for addiction treatment.
The most direct and easiest way of checking is to call the Find Addiction Rehabs hotline and inquire about the levels of coverage you have for treatment, and what facilities they offer that are in-network with Ambetter.
Alternatively, you may check the Find Addiction Rehabs website to find the best treatment options and top rehab centers that fit your needs.
Just type the specific treatment process you seek on the space provided and your location or the city where you want to undergo your addiction treatment. You will get results in seconds and can then figure out if the specific rehab center accepts Ambetter insurance.
If the treatment provider you found isn’t the one you are looking for, try looking for another one on our site. It’s so convenient – plus, it offers all the necessary information you need when seeking drug and alcohol rehab.
For those who have found their match as far as addiction treatment goes, the next step is to identify the right treatment programs.
What Are The Types Of Ambetter Substance Abuse Treatment?
Ambetter health insurance, at the minimum, offers drug and alcohol addiction treatment coverage. You only need to inquire from Find Addiction Rehabs about the exact amount covered and how much will be your out-of-pocket costs.
Here are the addiction treatment programs covered by the Ambetter insurance company:
1. Detox Services
Detoxification is critical to any treatment program because most people with drug and alcohol use disorders are already dependent on the substance. This means they could no longer function without either drugs or alcohol in their system. That’s why most of the toxins must be expelled from their body.
To be clear, detox is not a treatment. It’s just one step for the addicted to get better and clean up their systems. The procedure should be done at a drug and alcohol rehab facility for safety reasons, with a medical team on standby in case the situation gets worse.
Detox could lead to withdrawal symptoms, an unpleasant reaction to the loss of drug or alcohol in the system. For some, it isn’t too bad. They may just sweat profusely and feel uncomfortable. However, it could be serious for others who might experience any of the following:
- Delirium tremens
- Extreme sweating
- Nausea and vomiting
- Unstable blood pressure and heart rate
Some of these reactions can be fatal. Delirium tremens, for example, make one restless and upset or confused at times, which might lead to something dangerous. Certain individuals may also experience fever and seizures. Inpatient treatment is ideal for a detox procedure so the patient could be properly monitored by healthcare specialists.
Detox and medically supervised detox are a basic part of Ambetter insurance benefits.
2. Inpatient Rehab
With inpatient rehab, the patient with drug and alcohol addiction checks into a treatment center for onsite addiction treatment that lasts for at least two weeks and may go on for 30, 60, or 90 days. The completed inpatient treatment really depends on the patient’s needs because treatment is a journey—people have different ways of reaching their destination.
An essential part of both inpatient and outpatient treatment is counseling. Every person seeking drug and alcohol treatment must undergo one-on-one counseling with a specialist. Group sessions with others who are in the same boat are also required. Sharing experiences with those going through the same thing is a good way to express oneself and cope with the condition.
Counseling with family is likewise important during substance abuse treatment. Indeed, the rehab patient is not the only one affected by their addiction and mental health issues. Some family members may be the catalyst, but in most cases, the entire brood suffers when one has a drug or alcohol addiction. Open communication is imperative for everyone to move forward.
If you are interested in inpatient addiction and mental health services, we can help check whether your selected facility offers inpatient Ambetter insurance coverage. When enrolling in this program, you can also include Detox as a part of it.
3. Residential Treatment Program
Similar to the inpatient program, this one also involves staying inside a facility for the duration of the addiction treatment. The difference is that in residential treatment, one isn’t constrained to a strict rehabilitation schedule. Many people who enroll in residential drug and alcohol addiction treatment may not even need detox services.
Most individuals who opt for residential treatment programs need restricted access to drugs and alcohol, so they purposely check into a drug and alcohol rehab facility.
Ambetter insurance also covers residential programs but confirm with your insurance provider to be on the safe side.
4. Outpatient Drug and Alcohol Treatment
For those who have substance abuse problems but are not necessarily dependent on drugs and/or alcohol, the outpatient program is ideal. Usually, it only requires attending a 1-hour session once or twice a week. Some sessions involve one-on-one counseling while others are designed for group therapy.
The outpatient program is a private and convenient solution because it won’t disrupt your life. If you can’t afford to stop working, then outpatient rehabilitation will do, as long as you strictly abide by the program. This is among the treatment options that may not make a large dent in your insurance coverage.
5. Intensive Outpatient Drug and Alcohol Addiction Treatment
For those who need more intensive outpatient treatment, the sessions are around two to three hours with two to three sessions every week. There is also a strict program to follow even if they don’t stay inside rehab center facilities full time. It’s ideal for people who need intensive intervention but cannot afford to leave their jobs for months. This type of program requires dedication and commitment on the client’s part.
How To Choose The Right Treatment Center for Your Needs
Rehab centers are not all equal: some are overall superior in their offerings to others, and some will be better for your needs than others as well. Choosing the right treatment center with efficient drug and alcohol addiction programs along with mental health services is key to full recovery.
How can you identify the important qualities of a good rehab center?
1. Find Rehabs that Accept Ambetter Insurance
Obviously, this is a vital consideration because drug and alcohol addiction programs and the behavioral health industry cost money. Efficient treatment also needs to be long-term, which means you should have the best possible Ambetter rehab coverage.
Moreover, to receive full benefits, your chosen rehab facility should be in-network with Ambetter health insurance. Full benefits don’t mean full coverage, by the way, only the maximum that your plan offers for your specific situation and circumstances.
Calling Find Addiction Rehabs can help you sort out both the types of coverage you have for treatment, as well as a list of covered rehab options, often within minutes.
To help you narrow down in-network rehab facilities, here are the states with Ambetter coverage:
- New Hampshire
- New Mexico
- North Carolina
- South Carolina
2. Know the Facility’s Reputation
Research your treatment provider and their offerings, as it affects your well-being and might impact your recovery as well. For starters, a facility that accepts Ambetter insurance is already a good indication.
Check the facilities’ websites and social media pages as well for reviews from their former patients.
3. Ask for a HIPAA Badge
An addiction treatment rehab center that displays this logo on its website indicates its compliance with the Health Insurance Portability and Accountability Act of 1996.
To qualify for a HIPAA badge, rehabs are required to hire a HIPAA compliance officer and all personnel should have undergone HIPAA awareness training.
4. Treatment Programs
The treatment programs offered by a treatment facility are the most important factors to consider. Does it have flexible treatment options where you can do either inpatient or outpatient programs? For the outpatient programs, do they provide an intensive option, too? In addition, is there a 24/7 medical staff in case of a medical emergency?
Make sure the treatment programs include mental health services, medication-assisted treatment, effective alcohol addiction programs, and efficient drug addiction treatment.
Be able to know and assess if a rehab facility is the right place for you. If you are traveling out of state for rehab, be aware of the presence of a family program and how the center encourages involvement by your loved ones. Depending on your circumstance, your family can be an important support system for your addiction treatment, especially if you opt for an inpatient program.
Out-of-state rehab centers can be particularly helpful if you wish to detach yourself from memories of your substance use and mental health disorders, and the benefits of traveling for treatment away from home can outweigh the negatives for many seeking help.
6. Learn About Outcomes
Don’t be afraid to ask the staff a lot of questions about their treatment methods and overall rehabilitation philosophy. According to reports, the average stay at a rehabilitation facility is 12 days.
Find out what usually happens when their clients stay for less than two weeks. Is it enough to keep a person off drugs and alcohol for a long time?
7. Know the Rehab’s Visitation Policies
Some patients want to heal alone but many prefer to have family and friends visit them. Spending time with the ones you love is therapeutic, too.
Drug and alcohol addiction can destroy relationships but being in a treatment program allows people to heal themselves and their damaged relationships with others. If personal visits are allowed, make sure you are comfortable with their setting and rules regarding such contact.
Get an Ambetter Treatment Program for Lasting Recovery Now
Getting into a treatment program is a private and convenient solution to substance abuse and mental health problems. However, healing is an ongoing process. Just because you walk out of the facility feeling well and like a whole new person, it doesn’t mean that the demons will stop haunting you.
The journey to full healing is long and tough. You need to have the discipline to continue outpatient treatment programs and therapy. Even if it’s been years since you’ve had drugs or alcohol in your system, it helps to continue with counseling sessions.
There are also many cases where those who’ve been through addiction become counselors. Most are actually great at the job because they are very familiar with the experience.
When it comes to insurance coverage, it’s advisable to continue paying the premiums for an Ambetter insurance plan with addiction treatment coverage. It can cover a medical emergency in case of relapse and comes with therapies, too. For those suffering from co-occurring mental health issues, the insurance coverage includes medications.
Locate Approved Ambetter Facilities Quickly With Our Support
It pays to know that you have control over your healthcare needs and that your insurance is required by law to cover addiction treatment and mental health services. Assess your medical and mental needs properly, and then choose the Ambetter insurance coverage plan that’s right for you.
Visit Find Addiction Rehabs as soon as possible to find a center that will check all your boxes and helpful recovery representatives will assist you in locating the rehabilitation facilities where you are eligible to enroll according to the needs you’ve specified.
Top Rehabs That Accept Ambetter: Only a Call Away!
In many cases, Find Addiction Rehabs can find a top Ambetter treatment facility within minutes that accepts your policy and can even provide same-day placement when desired. No matter the time of day or night, their hotline is available to answer questions and refer clients to licensed, accredited facilities across the United States.
If you or your loved one are struggling with alcohol or other substances, give yourself a break and reach out today!
* Disclaimer: Find Addiction Rehabs is not affiliated with or endorsed by Ambetter. Details about Ambetter’s coverage are intended for informational purposes only. The specific details of your Ambetter plan may vary and the specific treatment services you require may or may not be covered. Please call our representatives today for more definitive details on your plan and options.
Eric R. hails from Maine and does extensive work in the field of behavioral health as both a professional writer and passionate advocate for those suffering. From his own personal encounters with mental illness, he speaks to those seeking healthy relief from depression and anxiety and embraces wellness both personally and professionally. After losing friends and family to the darkness of suicide, Eric aims to educate and inform about the nature of treatment and render it accessible for all those seeking a way out of darkness and despair.